Peritonsillar Infections: Prospective Study of 100 Consecutive Cases

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Each reflects a separate stage in the evolution of the inflammatory process originating from an exudative tonsillar infection. Peritonsillar abscess is defined as a purulent collection located between the tonsillar capsule, the superior constrictor muscle of the pharynx and the palatopharyngeal muscle.<a class="elsevierStyleCrossRef" href="#bib0015">3</a> In the pathophysiology of peritonsillar infections, phlegmon would represent a stage prior to an abscess, in which the peritonsillar inflammation process is not limited.Although group A β-haemolytic streptococcus (Streptococcus pyogenes) is usually the pathogen involved in the aetiology of this entity,<a class="elsevierStyleCrossRef" href="#bib0020">4</a> in most cases the infection corresponds to a mixed flora of aerobic and anaerobic agents.<a class="elsevierStyleCrossRef" href="#bib0025">5</a>Since there are no clinical guidelines for the management of this disease, treatment varies between countries and even between hospitals within the same country, in aspects such as treatment regime (outpatient or inpatient), method of drainage and antibiotic therapy employed. If peritonsillar infections are not treated properly there is a risk of developing serious complications such as thrombosis of the internal jugular vein, mediastinitis, pericarditis, pneumonia, formation of pseudoaneurysms and even sepsis.<a class="elsevierStyleCrossRefs" href="#bib0030">6,7</a> The mortality rate of patients who develop these complications can reach 42% in cases of mediastinitis or serositis.<a class="elsevierStyleCrossRef" href="#bib0040">8</a> Nevertheless, although occasionally the development of peritonsillar infection is torpid, morbidity and mortality are low if it is treated correctly, and hence the importance of knowing its anatomical characteristics, triggering factors, clinical aspects and therapeutic alternatives.<a class="elsevierStyleCrossRefs" href="#bib0045">9,10</a>The aim of this study is to review the diagnostic and therapeutic management of 100 consecutive cases collected at our service between the years 2008 and 2010.Materials and MethodsWe performed a descriptive, prospective study of the management of patients who were diagnosed and treated for peritonsillar infection between April 2008 and October 2010.The diagnosis of peritonsillar infection was mainly based on anamnesis and physical examination. We collected the following clinical variables: age, gender, history of recurrent tonsillitis, previous episodes of phlegmon/abscess, evolution, previous antibiotic therapy and its duration (the information was provided by patients or their relatives), symptoms at onset, physical examination findings and therapeutic procedure applied. We also recorded the length of hospital stay, treatment prescribed at discharge, recurrence of the process and performance of subsequent tonsillectomy.Following the protocol used in our department for the management of peritonsillar infections, all patients attending the Emergency Service with symptoms and exploration consistent with the diagnosis of peritonsillar infection were admitted for intravenous antibiotic therapy, analgesia and possible intravenous corticosteroids. According to Szuhay and Tewfik, a diagnosis of phlegmon or peritonsillar abscess was based primarily on the obtention of pus with needle aspiration performed on patients upon admission, in the region of maximum peritonsillar bulging.<a class="elsevierStyleCrossRef" href="#bib0055">11</a>The criteria for hospital discharge included clinical and analytical improvement of the patient.We used the statistical software SPSS 19.0 for Windows to conduct the statistical analysis.ResultsWe analysed 100 consecutive patients diagnosed with peritonsillar infection at our hospital between April 2008 and October 2010. <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> shows the main clinical and epidemiological characteristics of patients included in the study.<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>The ages of the patients included in the study ranged from 4 to 81 years, with a mean value of 34 years. As for gender, the ratio in adults was 1.1/1 in favour of males (53 males and 47 females).In total, 77% of patients had no documented history of repeated bacterial tonsillitis. In most patients (86%), the episode of peritonsillar infection was the first with these characteristics. However, in 9% of cases, the episode was a second occurrence and in 5% it was a third, fourth and even in 1 case, the fifth episode with the same characteristics. The vast majority (97%) had no prior history of tonsillectomy; nevertheless, 2 patients had undergone tonsillectomy in childhood.The time elapsed between onset of symptoms and diagnosis of the episode was a minimum of 2 and a maximum of 6 days, with a mean latency of 3 days. Less than half of patients (45%) had not received any doses of antibiotic treatment before attending the Emergency Service. Within the group of patients (55%) who were being treated with antibiotics as prescribed by their primary care physician, the most frequently used drug (49 patients) was a combination of amoxicillin/clavulanate at a dose of 500mg/125mg in 42 patients and 875mg/125mg in 7 patients. Only 2 patients were prescribed a macrolide (azithromycin 500mg) and 4 patients had taken both drugs consecutively before attending the Emergency Service. The mean duration of treatment prior to diagnosis was 2 days (range: 1–12 days).<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> shows the clinical characteristics of patients. The clinical symptoms characterised by odynodysphagia, fever, trismus, bulging of the anterior pillar, deviation of the uvula to the contralateral side and laterocervical lymphadenopathy were present in 77% of cases. In 30% of patients we did not find fever and trismus was absent in 23% of cases. The absence of trismus did not rule out the presence of peritonsillar abscess. In the haemogram which patients underwent upon admission, the mean value of leukocytes was 16,922/μl (7300–33400).<elsevierMultimedia ident="tbl0010"></elsevierMultimedia>As mentioned previously, upon admission all patients underwent puncture-aspiration in the most convex part of the anterior tonsillar pillar. No purulent material was obtained in 62 cases (62%), leakage of pus was observed in 32 cases (32%), in 5 patients (5%) we noted a spontaneous drainage of purulent material and in 1 case (1%) puncture was not performed at the time of diagnosis due to trismus. Based on this result we classified patients into those with a diagnosis of phlegmon, when there was no discharge of pus (62%), or abscess, when puncture led to the leakage of purulent material (38%). Clinical signs significantly associated with the presence of peritonsillar abscess were the presence of trismus (P<.001), contralateral deviation of the uvula (P<.001) and bulging of the anterior pillar of the affected side (P<.001). We did not find a significant association with the rest of the clinical data recorded.All patients were hospitalised and treated with intravenous antibiotics. The combination of amoxicillin/clavulanate 1000mg/200mg every 8h was the most widely used antibiotic treatment (83% of patients), followed by the association between clindamycin 600mg every 8h and gentamicin 240mg every 24h (14% of patients). Three patients received amoxicillin/clavulanate according to the previous dosage but, due to lack of favourable evolution after 5 days, were changed to a combination of clindamycin and gentamicin as described above. In all cases, antibiotic treatment was carried out empirically and duration of intravenous therapy varied between 1 day (only 1 case was treated for 24h) and 7 days. Most patients (82%) received intravenous antibiotic treatment for at least 3 days. All patients were given a dose of intravenous corticosteroids (methylprednisolone 1mg/kg) upon admission, as well as intravenous analgesia. All patients evolved satisfactorily and we did not observe progress of the infection to more serious complications.All patients received oral antibiotic therapy at discharge for 7 days. Treatment consisted in amoxicillin/clavulanate 1000mg/62.5mg, in 2 tablets every 12h in 83% of cases and clindamycin 300mg every 6h in 17% of cases.These cases of peritonsillar infection were the first collected during the time of study in 95% of patients, whilst 1% experienced a new episode and 4% presented 2 consecutive episodes. In 26 cases (26%) we suggested performing tonsillectomy after the episode of peritonsillar infection.DiscussionMost studies published in current literature are based on a retrospective analysis of cases. Thus, their results reflect the management of this condition in 10–15 years evolution. In order to reduce the heterogeneity inherent to most retrospective series, we have chosen to analyse prospectively 100 consecutive cases treated at our hospital according to the same diagnostic and therapeutic protocol.In our series, 55% of patients were receiving antibiotic therapy for the treatment of pharyngotonsillitis. This finding is more consistent with the classical concept that peritonsillar infection is due to a torpid evolution of bacterial tonsillitis. However, this percentage is higher than that described in the literature, where prior pharyngotonsillar infection was only reported in between 11% and 45% of cases.<a class="elsevierStyleCrossRefs" href="#bib0060">12,13</a> The absence of prior tonsillar infection would support the theory that the origin of peritonsillar infection is cellulitis of Weber's salivary glands. These small mucous glands are located in the superior pole of the tonsillar bed and the soft palate. When cellulitis of these glands takes place and inflammation progresses, it leads to symptoms which are clinically indistinguishable from those caused when a tonsillar infection does not evolve favourably. This observation would also justify the development of peritonsillar infections in patients who had undergone prior tonsillectomy.<a class="elsevierStyleCrossRefs" href="#bib0070">14,15</a>The diagnosis of this entity is simple and is based on clinical data and physical exploration.<a class="elsevierStyleCrossRef" href="#bib0005">1</a> It is characterised by the presence of unilateral inflammatory signs and symptoms, even in the absence of febrile syndrome. The presence of trismus, bulging of the anterior pillar and deviation of the uvula to the contralateral side can help to distinguish between a phlegmonous early stage and peritonsillar abscess without requiring puncture. While this datum confirms the reports published by Kilty et al.,<a class="elsevierStyleCrossRef" href="#bib0080">16</a> it should be taken with caution since, as seen in our study, up to 23% of cases do not present significant trismus. Some authors advocate the use of ultrasound for diagnosis and to conduct guided punctures, as well as computed tomography (CT) in uncooperative paediatric patients.<a class="elsevierStyleCrossRef" href="#bib0005">1</a>One of the hypotheses which we considered at the beginning of the study was that an inappropriate use of antibiotics in the treatment of pharyngitis favoured the development of complications, specifically the use of macrolides, due to the high rate of resistance among the Spanish population. However, although most patients were taking antibiotics at the time of diagnosis of peritonsillar infection, we found that only 3% of patients who had taken antibiotics previously had taken a macrolide and most were being treated adequately with amoxicillin/clavulanate. Nevertheless, we believe that not taking the appropriate dosage or failure to adequately comply with the correct antibiotic pattern could be a favouring factor since most authors report a higher rate of peritonsillar infections in patients treated with macrolides.<a class="elsevierStyleCrossRef" href="#bib0045">9</a> In our series we found no relationship between a history of repeated pharyngotonsillitis and the development of peritonsillar infection. This coincides with the findings in other series.<a class="elsevierStyleCrossRef" href="#bib0010">2</a> However, we did observe a relationship between suffering repeated pharyngotonsillitis and suffering more than one episode of phlegmon/abscess.Management on an outpatient basis or hospitalisation of these patients is a source of disagreement between various authors (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>). While in countries such as the United Kingdom the vast majority of patients are admitted, in the United States they are mostly managed as outpatients.<a class="elsevierStyleCrossRef" href="#bib0120">24</a> In our series, following the protocol at our service, we admitted these patients in order to administer intravenous antibiotics and provide hydration and nutritional support. Nevertheless, we believe that, following the therapeutic regime of Al Yaghchi et al.,<a class="elsevierStyleCrossRef" href="#bib0125">25</a> certain patients without risk factors could benefit from outpatient management.<elsevierMultimedia ident="tbl0015"></elsevierMultimedia>Drainage of the purulent material is part of the treatment (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>). The most appropriate method for this task remains controversial, although both puncture-aspiration and incision-drainage seem to be equally effective.<a class="elsevierStyleCrossRefs" href="#bib0090">18,21</a> In our action protocol, we use puncture-aspiration at the time of diagnosis. According to the leakage or not of purulent material, we classify the infection as phlegmon or abscess. The management guide for peritonsillar abscesses proposed by Herzon et al.<a class="elsevierStyleCrossRef" href="#bib0060">12</a> suggests that puncture-aspiration can be used as the only drainage procedure, as it obtains a resolution rate of 96%, and leaves incision-drainage as an alternative for cases of failure of the first technique. These authors emphasise the scarce discomfort, technical simplicity and low cost of the technique, as well as the fact that it does not require specialised equipment. Some authors advocate performing tonsillectomy immediately after draining the abscess (quinsy or hot tonsillectomy) due to the low rate of complications and recurrences.<a class="elsevierStyleCrossRef" href="#bib0130">26</a> In our study, most patients evolved adequately without having to repeat the puncture or perform an incision for drainage.Antibiotic treatment was established empirically, with the first option being intravenous amoxicillin-clavulanate at high doses. This treatment progressed adequately in 84% of cases, including those previously treated with this same combination. From this we can conclude that most resistances remain dose-dependent. We believe that a combination of clindamycin and gentamicin may be an adequate alternative in cases of β-lactam allergy or unfavourable evolution with the first option. Other authors advocate the use of cefotaxime or penicillin alone or combined with metronidazole, with similar results.<a class="elsevierStyleCrossRefs" href="#bib0065">13,27</a> We believe that administration of a single dose of corticosteroids can be very useful, having observed, like other authors, a faster improvement of symptoms such as dysphagia, pain and trismus.<a class="elsevierStyleCrossRef" href="#bib0140">28</a>In accordance with other authors,<a class="elsevierStyleCrossRef" href="#bib0145">29</a> we believe that microbiological identification studies are unnecessary, since empirical therapy is generally effective before culture results are obtained. In addition, many patients take antibiotics previously, so, very often, the results of the culture do not identify the causative agent. Conducting cultures and antibiograms would only be useful in cases of infections with very unfavourable evolution and in immunocompromised patients.According to Wikstén et al. the risk of recurrence is 10%–15% depending on the follow-up period. This rate increases to 50% in patients younger than 40 years and in those with a history of repeated infections.<a class="elsevierStyleCrossRef" href="#bib0150">30</a> Our recurrence rate was 5%, which would confirm the effectiveness of our protocol.Regarding the indication for tonsillectomy after an episode of peritonsillar infection, as described in the literature,<a class="elsevierStyleCrossRefs" href="#bib0045">9,31</a> we do not consider having suffered such an episode as an absolute criterion for the intervention. However, in patients with repeated pharyngotonsillitis and in those cases with more than one peritonsillar event, we support the indication of delayed tonsillectomy.We have not collected any cases of serious complications during this time period, since cases of mediastinitis, necrotising fasciitis or septic embolisms are more common in severely immunocompromised patients or in those who have suffered a major delay in diagnosis.<a class="elsevierStyleCrossRef" href="#bib0160">32</a>ConclusionsPeritonsillar infection is the most common complication of bacterial pharyngotonsillitis. Although this entity is likely to cause high morbidity and mortality, it has an excellent prognosis when properly treated.Due to the absence of clinical practice guidelines for the management of this disorder there are various treatment protocols. From our experience, we believe that puncture-aspiration in the most convex peritonsillar region and administration of intravenous antibiotics represents a safe and effective protocol in the management of these patients. Further, controlled studies would be required in order to determine the efficacy and safety of management on an outpatient basis compared to hospital admission.Conflict of InterestsThe authors have no conflicts of interest to declare." "textoCompletoSecciones" => array:1 [ "secciones" => array:11 [ 0 => array:2 [ "identificador" => "xres94993" "titulo" => array:5 [ 0 => "Abstract" 1 => "Introduction" 2 => "Material and methods" 3 => "Results" 4 => "Conclusions" ] ] 1 => array:2 [ "identificador" => "xpalclavsec82144" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "xres94992" "titulo" => array:5 [ 0 => "Resumen" 1 => "Introducción" 2 => "Material y métodos" 3 => "Resultados" 4 => "Conclusiones" ] ] 3 => array:2 [ "identificador" => "xpalclavsec82145" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Materials and Methods" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "Conclusions" ] 9 => array:2 [ "identificador" => "sec0030" "titulo" => "Conflict of Interests" ] 10 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2011-10-25" "fechaAceptado" => "2012-01-02" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec82144" "palabras" => array:4 [ 0 => "Peritonsillar infection" 1 => "Abscess" 2 => "Cellulitis" 3 => "Tonsillitis" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec82145" "palabras" => array:4 [ 0 => "Infección periamigdalina" 1 => "Absceso" 2 => "Flemón" 3 => "Amigdalitis" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "IntroductionPeritonsillar infection is the most frequent complication of acute tonsillitis. Peritonsillar infections are collections of purulent material, usually located between the tonsillar capsule and the superior constrictor of the pharynx. Peritonsillar infection can be divided into abscess and cellulitis. Material and methodsWe prospectively analysed the clinical data from 100 patients with peritonsillar infection from 2008 to 2010. The diagnosis of abscess or peritonsillar cellulitis was primarily based on obtaining pus through fine-needle aspiration. ResultsSeventy-seven percent of patients had no history of recurrent tonsillitis and 55% were receiving antibiotic treatment. Sixty-two cases were peritonsillar abscess and the rest were cellulitis. Trismus, uvular deviation and anterior pillar bulging were statistically associated with peritonsillar abscess (P<.005). All patients were admitted to hospital and treated with puncture-drainage, intravenous antibiotics (amoxicillin/clavulanate in 83% of cases) and a single dose of steroids. All patients were discharged on oral antibiotic therapy. The mean length of hospital stay was 3 days and the recurrence rate was 5%. ConclusionsDue to the absence of clinical practice guidelines, there are different therapeutic protocols. According to our experience, puncture-aspiration and administration of intravenous antibiotics is a safe, effective way to treat these patients. To determine the efficacy and safety of outpatient management, controlled studies would be needed." ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "IntroducciónLa infección periamigdalina supone la complicación más frecuente de una amigdalitis. Se define como una colección purulenta localizada entre la cápsula amigdalar y el músculo constrictor superior de la faringe. Puede clasificarse en flemón y absceso periamigdalino. Material y métodosPresentamos un estudio prospectivo descriptivo de 100 infecciones periamigdalinas diagnosticadas entre los años 2008 y 2010. Se analizaron diversas variables clínico-epidemiológicas y el manejo de estos pacientes. El diagnóstico de flemón o absceso periamigdalino se basó fundamentalmente en la obtención de pus mediante punción-aspiración. ResultadosEl 77% de los pacientes no tenían antecedentes de amigdalitis de repetición y el 55% estaban recibiendo tratamiento antibiótico. En el 62% de los casos se clasificó como absceso y en el 38% como flemón periamigdalino. La presencia de trismus, desviación contralateral de la úvula y el abombamiento del pilar anterior se relacionó con la presencia de absceso (p<0,001). Todos los pacientes fueron ingresados y tratados con punción-drenaje, antibioterapia intravenosa (amoxicilina/clavulánico en el 83% de los casos) y una dosis de corticoides. Al alta, todos los pacientes recibieron antibioterapia oral. La estancia media fue de 3 días y la tasa de recurrencias del 5%. ConclusionesDebido a la ausencia de guías de práctica clínica, existen diversos protocolos terapéuticos. De acuerdo a nuestra experiencia, la punción-aspiración y la administración de antibioterapia intravenosa, es una opción segura y eficaz en el manejo de estos pacientes. Para determinar la eficacia y seguridad del manejo ambulatorio o mediante ingreso de estos pacientes, serían necesarios estudios controlados." ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Costales-Marcos M, et al. Infecciones periamigdalinas: estudio prospectivo de 100 casos consecutivos. Acta Otorrinolaringol Esp. 2012;63:212–7." ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Characteristics \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Gender</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">53 (53%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">47 (47%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Mean age \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">34 years (4–81 years) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Repeated tonsillitis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">23 (23%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Previous peritonsillar infection \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14 (14%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Laterality</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Left \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">59 (59%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Right \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">41 (41%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Mean latency until diagnosis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 days (2–7 days) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Prior antibiotic therapy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">55 (55%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Diagnosis</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Phlegmon \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">62 (62%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Abscess \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">38 (38%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Treatment</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Intravenous amoxicillin/clavulanate \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">83 (83%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Mean hospital stay \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 days (1–7 days) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Recurrences \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 (5%) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Subsequent tonsillectomy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">26 (26%) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab179787.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Main Clinical and Epidemiological Characteristics." ] ] 1 => array:7 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Symptom/sign \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">No. of patients, % \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Odynodysphagia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">100 (100) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Bulging of anterior pillar \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">98 (98) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Contralateral displacement of uvula \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">95 (95) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cervical lymphadenopathies \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">80 (80) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Fever \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">70 (70) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Trismus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">77 (77) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Ptyalism \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">68 (68) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Dysphonia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">40 (40) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Uvula hydrops \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">28 (28) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Dyspnoea \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 (13) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab179785.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "Patients normally presented more than 1 symptom." ] ] ] "descripcion" => array:1 [ "en" => "Presentation Symptoms in 100 Patients With Peritonsillar Infection.<a class="elsevierStyleCrossRef" href="#tblfn0005">a</a>" ] ] 2 => array:7 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Authors \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Treatment regime \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Number of patients \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Method \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Success, % \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Mehanna et al.<a class="elsevierStyleCrossRef" href="#bib0085">17</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">94% hospital \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">101 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">48% punction \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">92 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6% outpatient \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">52% incision \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">90 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Ong et al.<a class="elsevierStyleCrossRef" href="#bib0065">13</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">100% hospital \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">185 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">66% incision \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">93 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">34% punction \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">41 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Stringer et al.<a class="elsevierStyleCrossRef" href="#bib0090">18</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">100% outpatient \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">24 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Punction \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">92 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">28 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Incision \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">93 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Herzon et al.<a class="elsevierStyleCrossRef" href="#bib0060">12</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">100% outpatient \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">41 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">100% punction \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">90 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Ophir et al.<a class="elsevierStyleCrossRef" href="#bib0095">19</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">92% outpatient \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">75 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">100% punction \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">52 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8% hospital \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Segal et al.<a class="elsevierStyleCrossRef" href="#bib0100">20</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">100% outpatient \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">126 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">75.4% punction 23.8% incision 0.8% quinsy tonsillectomy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">96 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">98 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">100 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Spires et al.<a class="elsevierStyleCrossRef" href="#bib0105">21</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">100% outpatient \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">41 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Punction \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">98 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Incision \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">100 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Maharaj et al.<a class="elsevierStyleCrossRef" href="#bib0020">4</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">100% outpatient \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Punction \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">87 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Incision \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">90 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Savolainen et al.<a class="elsevierStyleCrossRef" href="#bib0110">22</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">100% hospital \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">98 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">100% punction \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">91 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Wolf et al.<a class="elsevierStyleCrossRef" href="#bib0115">23</a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">100% hospital \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">86 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Punction \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">28 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">74 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Incision \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">90 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab179786.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Comparative studies of drainage method and treatment regime." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:32 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The contemporary approach to diagnosis and management of peritonsillar abscess" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "R.F. Johnson" 1 => "M.G. Stewart" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Curr Opin Otolaryngol Head Neck Surg" "fecha" => "2005" "volumen" => "13" "paginaInicial" => "157" "paginaFinal" => "160" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15908813" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Absceso periamigdalino con extensión parotídea y perifaríngea. A propósito de un caso" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "G. Barroso Braojos" 1 => "E. Raboso García-Baquero" 2 => "J. Martínez Sanmillán" 3 => "A. Martínez Vidal" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Acta Otorrinolaringol Esp" "fecha" => "2000" "volumen" => "51" "paginaInicial" => "737" "paginaFinal" => "739" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11270112" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Abscesos periamigdalino y retrofaríngeo: estudio de 13 años" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E. Martín Campagne" 1 => "F. del Castillo Martín" 2 => "M.M. Martínez López" 3 => "C. Borque de Andrés" 4 => "M.I. de José Gómez" 5 => "M.J. García de Miguel" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "An Pediatr (Barc)" "fecha" => "2006" "volumen" => "65" "paginaInicial" => "32" "paginaFinal" => "36" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Management of peritonsillar abscess" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "D. Maharaj" 1 => "V. Rajah" 2 => "S. Hemsley" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Laryngol Otol" "fecha" => "1991" "volumen" => "105" "paginaInicial" => "743" "paginaFinal" => "745" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1919343" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Microbiology and management of peritonsillar, retropharyngeal, and parapharyngeal abscesses" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "I. Brook" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Oral Maxillofac Surg" "fecha" => "2004" "volumen" => "62" "paginaInicial" => "1545" "paginaFinal" => "1550" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15573356" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Rational diagnostic and therapeutic management of deep neck infections: analysis of 233 consecutive cases" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "G. Marioni" 1 => "A. Staffieri" 2 => "S. Parisi" 3 => "R. Marchese-Ragona" 4 => "A. Zuccon" 5 => "C. Staffieri" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ann Otol Rhinol Laryngol" "fecha" => "2010" "volumen" => "119" "paginaInicial" => "181" "paginaFinal" => "187" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20392031" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prediction of deep neck abscesses by contrast-enhanced computerized tomography in 76 clinically suspect consecutive patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "N. Freling" 1 => "E. Roele" 2 => "C. Schaefer-Prokop" 3 => "W. Fokkens" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/lary.20606" "Revista" => array:7 [ "tituloSerie" => "Laryngoscope" "fecha" => "2009" "volumen" => "119" "paginaInicial" => "1745" "paginaFinal" => "1752" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19551850" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0735109798001624" "estado" => "S300" "issn" => "07351097" ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Analysis of life-threatening complications of deep neck abscess and the impact of empiric antibiotics" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "S.V.V. Yang" 1 => "M.H. Lee" 2 => "Y.S. Lee" 3 => "S.H. Huang" 4 => "T.A. Chen" 5 => "T.J. Fang" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1159/000132094" "Revista" => array:6 [ "tituloSerie" => "ORL J Otorhinolaryngol Relat Spec" "fecha" => "2008" "volumen" => "70" "paginaInicial" => "249" "paginaFinal" => "526" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18483463" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Tratamiento de la infección periamigdalina" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "F.J. García Callejo" 1 => "F. Núñez Gómez" 2 => "J. Sala Franco" 3 => "J. Marco Algarra" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "An Pediatr (Barc)" "fecha" => "2006" "volumen" => "65" "paginaInicial" => "37" "paginaFinal" => "43" ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Peritonsillar abscess in early childhood. Presentation and management" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "N.R. Friedman" 1 => "R.B. Mitchell" 2 => "K.D. Pereira" 3 => "R.T. Younis" 4 => "R.H. Lazar" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Otolaryngol Head Neck Surg" "fecha" => "1997" "volumen" => "123" "paginaInicial" => "630" "paginaFinal" => "632" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9193226" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0055" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Peritonsillar abscess or cellulitis? A clinical comparative paediatric study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "G. Szuhay" 1 => "T.L. Tewfik" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Otolaryngol" "fecha" => "1998" "volumen" => "27" "paginaInicial" => "206" "paginaFinal" => "212" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9711515" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0060" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Mosher Award Thesis. Peritonsillar abscess: Incidence, current management practices, and a proposal treatment guidelines" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "F.S. Herzon" 1 => "P. Harris" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Laryngoscope" "fecha" => "1995" "volumen" => "105" "paginaInicial" => "117" ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0065" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Peritonsillar infections: local experience" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "Y.K. Ong" 1 => "Y.H. Goh" 2 => "Y.L. Lee" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Singapore Med J" "fecha" => "2004" "volumen" => "45" "paginaInicial" => "106" "paginaFinal" => "109" ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0070" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Peritonsillar abscess after tonsillectomy: a review of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S.E. Farmer" 1 => "M.A. Khatwa" 2 => "H.M. Zeitoun" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1308/003588411X579793" "Revista" => array:6 [ "tituloSerie" => "Ann R Coll Surg Engl" "fecha" => "2011" "volumen" => "93" "paginaInicial" => "353" "paginaFinal" => "355" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21943456" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0075" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Relation between peritonsillar infection and acute tonsillitis: myth or reality" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "S. Kordeluk" 1 => "L. Novack" 2 => "M. Puterman" 3 => "M. Kraus" 4 => "B.Z. Joshua" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1177/0194599811415802" "Revista" => array:6 [ "tituloSerie" => "Otolaryngol Head Neck Surg" "fecha" => "2011" "volumen" => "145" "paginaInicial" => "940" "paginaFinal" => "945" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21810775" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0080" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical predictors of peritonsillar abscess in adults" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S.J. Kilty" 1 => "I. Gaboury" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Otolaryngol Head Neck Surg" "fecha" => "2008" "volumen" => "37" "paginaInicial" => "165" "paginaFinal" => "168" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19128606" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0085" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "National audit of the management of peritonsillar abscess" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "H.M. Mehanna" 1 => "L. Al-Bahnasawi" 2 => "A. White" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Postgrad Med J" "fecha" => "2002" "volumen" => "78" "paginaInicial" => "545" "paginaFinal" => "548" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12357017" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0090" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A randomized trial for outpatient management of peritonsillar abscess" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S.P. Stringer" 1 => "S.D. Schaefer" 2 => "L.G. Close" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Otolaryngol Head Neck Surg" "fecha" => "1988" "volumen" => "114" "paginaInicial" => "296" "paginaFinal" => "298" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3422562" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0095" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Peritonsillar abscess. A prospective evaluation of outpatient management by needle aspiration" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "D. Ophir" 1 => "J. Bawnik" 2 => "Y. Poria" 3 => "M. Porat" 4 => "G. Marshak" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Otolaryngol Head Neck Surg" "fecha" => "1988" "volumen" => "114" "paginaInicial" => "661" "paginaFinal" => "663" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3163252" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0100" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Peritonsillar abscess in children in the southern district of Israel" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "N. Segal" 1 => "S. El-Saied" 2 => "M. Puterman" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ijporl.2009.04.021" "Revista" => array:6 [ "tituloSerie" => "Int J Pediatr Otorhinolaryngol" "fecha" => "2009" "volumen" => "73" "paginaInicial" => "1148" "paginaFinal" => "1150" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19481820" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0105" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Treatment of peritonsillar abscess. A prospective study of aspiration vs incision and drainage" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J.R. Spires" 1 => "J.J. Owens" 2 => "G.E. Woodson" 3 => "R.H. Miller" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Otolaryngol Head Neck Surg" "fecha" => "1987" "volumen" => "113" "paginaInicial" => "984" "paginaFinal" => "986" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3606850" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0110" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Peritonsillar abscess. Clinical and microbiologic aspects and treatment regimens" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S. Savolainen" 1 => "H.R. Jousimies-Somer" 2 => "A.A. Makitie" 3 => "J.S. Ylikoski" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Otolaryngol Head Neck Surg" "fecha" => "1993" "volumen" => "119" "paginaInicial" => "521" "paginaFinal" => "524" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8484941" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0115" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Peritonsillar abscess: repeated needle aspiration versus incision and drainage" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M. Wolf" 1 => "I. Even-Chen" 2 => "J. Kronenberg" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ann Otol Rhinol Laryngol" "fecha" => "1994" "volumen" => "103" "paginaInicial" => "554" "paginaFinal" => "557" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8024219" "web" => "Medline" ] ] ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0120" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prospective audit on the outpatient management of patients with a peritonsillar abscess: closing the loop: how we do it" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "G. Garas" 1 => "S. Ifeacho" 2 => "R. Cetto" 3 => "A. Arora" 4 => "N. Tolley" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1749-4486.2011.02255.x" "Revista" => array:6 [ "tituloSerie" => "Clin Otolaryngol" "fecha" => "2011" "volumen" => "36" "paginaInicial" => "174" "paginaFinal" => "179" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21518279" "web" => "Medline" ] ] ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0125" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Out-patient management of patients with a peritonsillar abscess" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "C. Al Yaghchi" 1 => "A. Cruise" 2 => "K. Kapoor" 3 => "A. Singh" 4 => "J. Harcourt" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1749-4486.2007.01575.x" "Revista" => array:6 [ "tituloSerie" => "Clin Otolaryngol" "fecha" => "2008" "volumen" => "33" "paginaInicial" => "52" "paginaFinal" => "55" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18302556" "web" => "Medline" ] ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib0130" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Peritonsillar abscess-critical analysis of abscess tonsillectomy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "A.A. Dunne" 1 => "O. Granger" 2 => "B.J. Folz" 3 => "A. Sesterhenn" 4 => "J.A. Werner" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Clin Otolaryngol" "fecha" => "2003" "volumen" => "28" "paginaInicial" => "420" "paginaFinal" => "424" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12969344" "web" => "Medline" ] ] ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib0135" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The microbiology and antibiotic treatment of peritonsillar abscess" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A. Prior" 1 => "P. Montgomery" 2 => "I. Mitchelmore" 3 => "S. Tabaqchali" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Clin Otolaryngol" "fecha" => "1995" "volumen" => "20" "paginaInicial" => "219" "paginaFinal" => "223" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7554331" "web" => "Medline" ] ] ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib0140" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Use of steroids in the treatment of peritonsillar abscess" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "C. Ozbek" 1 => "E. Aygenc" 2 => "E.U. Tuna" 3 => "A. Selcuk" 4 => "C. Ozdem" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1258/002221504323219563" "Revista" => array:6 [ "tituloSerie" => "J Laryngol Otol" "fecha" => "2004" "volumen" => "118" "paginaInicial" => "439" "paginaFinal" => "442" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15285862" "web" => "Medline" ] ] ] ] ] ] ] ] 28 => array:3 [ "identificador" => "bib0145" "etiqueta" => "29" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Use of bacteriologic studies in the management of peritonsillar abscess" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "T.G. Nelson" 1 => "T. Hayat" 2 => "H. Jones" 3 => "M.D. Weller" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1749-4486.2008.01861.x" "Revista" => array:6 [ "tituloSerie" => "Clin Otolaryngol" "fecha" => "2009" "volumen" => "34" "paginaInicial" => "88" "paginaFinal" => "89" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19260906" "web" => "Medline" ] ] ] ] ] ] ] ] 29 => array:3 [ "identificador" => "bib0150" "etiqueta" => "30" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Who ends up having tonsillectomy after peritonsillar infection?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J. Wikstén" 1 => "M. Hytönen" 2 => "A. Pitkäranta" 3 => "K. Blomgren" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00405-007-0306-0" "Revista" => array:3 [ "tituloSerie" => "Eur Arch Otorhinolaryngol" "fecha" => "2011" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17453227" "web" => "Medline" ] ] ] ] ] ] ] ] 30 => array:3 [ "identificador" => "bib0155" "etiqueta" => "31" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Quinsy tonsillectomy or interval tonsillectomy-a prospective randomised trial" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J.J. Fagan" 1 => "P.J. Wormald" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "S Afr Med J" "fecha" => "1994" "volumen" => "84" "paginaInicial" => "689" "paginaFinal" => "690" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7839259" "web" => "Medline" ] ] ] ] ] ] ] ] 31 => array:3 [ "identificador" => "bib0160" "etiqueta" => "32" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Parapharyngeal abscess: diagnosis, complications and management in adults" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "A. Alaani" 1 => "H. Griffiths" 2 => "S.S. Minhas" 3 => "J. Olliff" 4 => "A.B. Lee" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00405-004-0800-6" "Revista" => array:6 [ "tituloSerie" => "Eur Arch Otorhinolaryngol" "fecha" => "2005" "volumen" => "262" "paginaInicial" => "345" "paginaFinal" => "350" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15235797" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735735/0000006300000003/v1_201304231514/S2173573512000531/v1_201304231514/en/main.assets" "Apartado" => array:4 [ "identificador" => "5871" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Original articles" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735735/0000006300000003/v1_201304231514/S2173573512000531/v1_201304231514/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173573512000531?idApp=UINPBA00004N"]

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Peritonsillar Infections: Prospective Study of 100 Consecutive Cases

Infecciones periamigdalinas: estudio prospectivo de 100 casos consecutivos

María Costales-Marcos

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Costi2@hotmail.com

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, Fernando López-Álvarez, Faustino Núñez-Batalla, Carla Moreno-Galindo, César Álvarez Marcos, José Luis Llorente-Pendás

Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Oviedo, Principado de Asturias, Spain

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Peritonsillar abscess is defined as a purulent collection located between the tonsillar capsule&#44; the superior constrictor muscle of the pharynx and the palatopharyngeal muscle&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> In the pathophysiology of peritonsillar infections&#44; phlegmon would represent a stage prior to an abscess&#44; in which the peritonsillar inflammation process is not limited&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Although group A &#946;-haemolytic streptococcus &#40;<span class="elsevierStyleItalic">Streptococcus pyogenes</span>&#41; is usually the pathogen involved in the aetiology of this entity&#44;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> in most cases the infection corresponds to a mixed flora of aerobic and anaerobic agents&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Since there are no clinical guidelines for the management of this disease&#44; treatment varies between countries and even between hospitals within the same country&#44; in aspects such as treatment regime &#40;outpatient or inpatient&#41;&#44; method of drainage and antibiotic therapy employed&#46; If peritonsillar infections are not treated properly there is a risk of developing serious complications such as thrombosis of the internal jugular vein&#44; mediastinitis&#44; pericarditis&#44; pneumonia&#44; formation of pseudoaneurysms and even sepsis&#46;<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6&#44;7</span></a> The mortality rate of patients who develop these complications can reach 42&#37; in cases of mediastinitis or serositis&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> Nevertheless&#44; although occasionally the development of peritonsillar infection is torpid&#44; morbidity and mortality are low if it is treated correctly&#44; and hence the importance of knowing its anatomical characteristics&#44; triggering factors&#44; clinical aspects and therapeutic alternatives&#46;<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">9&#44;10</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">The aim of this study is to review the diagnostic and therapeutic management of 100 consecutive cases collected at our service between the years 2008 and 2010&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Materials and Methods</span><p id="par0025" class="elsevierStylePara elsevierViewall">We performed a descriptive&#44; prospective study of the management of patients who were diagnosed and treated for peritonsillar infection between April 2008 and October 2010&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The diagnosis of peritonsillar infection was mainly based on anamnesis and physical examination&#46; We collected the following clinical variables&#58; age&#44; gender&#44; history of recurrent tonsillitis&#44; previous episodes of phlegmon&#47;abscess&#44; evolution&#44; previous antibiotic therapy and its duration &#40;the information was provided by patients or their relatives&#41;&#44; symptoms at onset&#44; physical examination findings and therapeutic procedure applied&#46; We also recorded the length of hospital stay&#44; treatment prescribed at discharge&#44; recurrence of the process and performance of subsequent tonsillectomy&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Following the protocol used in our department for the management of peritonsillar infections&#44; all patients attending the Emergency Service with symptoms and exploration consistent with the diagnosis of peritonsillar infection were admitted for intravenous antibiotic therapy&#44; analgesia and possible intravenous corticosteroids&#46; According to Szuhay and Tewfik&#44; a diagnosis of phlegmon or peritonsillar abscess was based primarily on the obtention of pus with needle aspiration performed on patients upon admission&#44; in the region of maximum peritonsillar bulging&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">The criteria for hospital discharge included clinical and analytical improvement of the patient&#46;We used the statistical software SPSS 19&#46;0 for Windows to conduct the statistical analysis&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Results</span><p id="par0050" class="elsevierStylePara elsevierViewall">We analysed 100 consecutive patients diagnosed with peritonsillar infection at our hospital between April 2008 and October 2010&#46; <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> shows the main clinical and epidemiological characteristics of patients included in the study&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">The ages of the patients included in the study ranged from 4 to 81 years&#44; 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had not received any doses of antibiotic treatment before attending the Emergency Service&#46; Within the group of patients &#40;55&#37;&#41; who were being treated with antibiotics as prescribed by their primary care physician&#44; the most frequently used drug &#40;49 patients&#41; was a combination of amoxicillin&#47;clavulanate at a dose of 500<span class="elsevierStyleHsp" style=""></span>mg&#47;125<span class="elsevierStyleHsp" style=""></span>mg in 42 patients and 875<span class="elsevierStyleHsp" style=""></span>mg&#47;125<span class="elsevierStyleHsp" style=""></span>mg in 7 patients&#46; Only 2 patients were prescribed a macrolide &#40;azithromycin 500<span class="elsevierStyleHsp" style=""></span>mg&#41; and 4 patients had taken both drugs consecutively before attending the Emergency Service&#46; The mean duration of treatment prior to diagnosis was 2 days &#40;range&#58; 1&#8211;12 days&#41;&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> shows the clinical characteristics of patients&#46; The clinical symptoms characterised by odynodysphagia&#44; fever&#44; trismus&#44; bulging of the anterior pillar&#44; deviation of the uvula to the contralateral side and laterocervical lymphadenopathy were present in 77&#37; of cases&#46; In 30&#37; of patients we did not find fever and trismus was absent in 23&#37; of cases&#46; The absence of trismus did not rule out the presence of peritonsillar abscess&#46; In the haemogram which patients underwent upon admission&#44; the mean value of leukocytes was 16&#44;922&#47;&#956;l &#40;7300&#8211;33<span class="elsevierStyleHsp" style=""></span>400&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">As mentioned previously&#44; upon admission all patients underwent puncture-aspiration in the most convex part of the anterior tonsillar pillar&#46; No purulent material was obtained in 62 cases &#40;62&#37;&#41;&#44; leakage of pus was observed in 32 cases &#40;32&#37;&#41;&#44; in 5 patients &#40;5&#37;&#41; we noted a spontaneous drainage of purulent material and in 1 case &#40;1&#37;&#41; puncture was not performed at the time of diagnosis due to trismus&#46; Based on this result we classified patients into those with a diagnosis of phlegmon&#44; when there was no discharge of pus &#40;62&#37;&#41;&#44; or abscess&#44; when puncture led to the leakage of purulent material &#40;38&#37;&#41;&#46; Clinical signs significantly associated with the presence of peritonsillar abscess were the presence of trismus &#40;<span class="elsevierStyleItalic">P</span>&#60;&#46;001&#41;&#44; contralateral deviation of the uvula &#40;<span class="elsevierStyleItalic">P</span>&#60;&#46;001&#41; and bulging of the anterior pillar of the affected side &#40;<span class="elsevierStyleItalic">P</span>&#60;&#46;001&#41;&#46; We did not find a significant association with the rest of the clinical data recorded&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">All patients were hospitalised and treated with intravenous antibiotics&#46; The combination of amoxicillin&#47;clavulanate 1000<span class="elsevierStyleHsp" style=""></span>mg&#47;200<span class="elsevierStyleHsp" style=""></span>mg every 8<span class="elsevierStyleHsp" style=""></span>h was the most widely used antibiotic treatment &#40;83&#37; of patients&#41;&#44; followed by the association between clindamycin 600<span class="elsevierStyleHsp" style=""></span>mg every 8<span class="elsevierStyleHsp" style=""></span>h and gentamicin 240<span class="elsevierStyleHsp" style=""></span>mg every 24<span class="elsevierStyleHsp" style=""></span>h &#40;14&#37; of patients&#41;&#46; Three patients received amoxicillin&#47;clavulanate according to the previous dosage but&#44; due to lack of favourable evolution after 5 days&#44; were changed to a combination of clindamycin and gentamicin as described above&#46; In all cases&#44; antibiotic treatment was carried out empirically and duration of intravenous therapy varied between 1 day &#40;only 1 case was treated for 24<span class="elsevierStyleHsp" style=""></span>h&#41; and 7 days&#46; Most patients &#40;82&#37;&#41; received intravenous antibiotic treatment for at least 3 days&#46; All patients were given a dose of intravenous corticosteroids &#40;methylprednisolone 1<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#41; upon admission&#44; as well as intravenous analgesia&#46; All patients evolved satisfactorily and we did not observe progress of the infection to more serious complications&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">All patients received oral antibiotic therapy at discharge for 7 days&#46; Treatment consisted in amoxicillin&#47;clavulanate 1000<span class="elsevierStyleHsp" style=""></span>mg&#47;62&#46;5<span class="elsevierStyleHsp" style=""></span>mg&#44; in 2 tablets every 12<span class="elsevierStyleHsp" style=""></span>h in 83&#37; of cases and clindamycin 300<span class="elsevierStyleHsp" style=""></span>mg every 6<span class="elsevierStyleHsp" style=""></span>h in 17&#37; of cases&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">These cases of peritonsillar infection were the first collected during the time of study in 95&#37; of patients&#44; whilst 1&#37; experienced a new episode and 4&#37; presented 2 consecutive episodes&#46; In 26 cases &#40;26&#37;&#41; we suggested performing tonsillectomy after the episode of peritonsillar infection&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Discussion</span><p id="par0095" class="elsevierStylePara elsevierViewall">Most studies published in current literature are based on a retrospective analysis of cases&#46; Thus&#44; their results reflect the management of this condition in 10&#8211;15 years evolution&#46; In order to reduce the heterogeneity inherent to most retrospective series&#44; we have chosen to analyse prospectively 100 consecutive cases treated at our hospital according to the same diagnostic and therapeutic protocol&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">In our series&#44; 55&#37; of patients were receiving antibiotic therapy for the treatment of pharyngotonsillitis&#46; This finding is more consistent with the classical concept that peritonsillar infection is due to a torpid evolution of bacterial tonsillitis&#46; However&#44; this percentage is higher than that described in the literature&#44; where prior pharyngotonsillar infection was only reported in between 11&#37; and 45&#37; of cases&#46;<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">12&#44;13</span></a> The absence of prior tonsillar infection would support the theory that the origin of peritonsillar infection is cellulitis of Weber&#39;s salivary glands&#46; These small mucous glands are located in the superior pole of the tonsillar bed and the soft palate&#46; When cellulitis of these glands takes place and inflammation progresses&#44; it leads to symptoms which are clinically indistinguishable from those caused when a tonsillar infection does not evolve favourably&#46; This observation would also justify the development of peritonsillar infections in patients who had undergone prior tonsillectomy&#46;<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">14&#44;15</span></a></p><p id="par0105" class="elsevierStylePara elsevierViewall">The diagnosis of this entity is simple and is based on clinical data and physical exploration&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> It is characterised by the presence of unilateral inflammatory signs and symptoms&#44; even in the absence of febrile syndrome&#46; The presence of trismus&#44; bulging of the anterior pillar and deviation of the uvula to the contralateral side can help to distinguish between a phlegmonous early stage and peritonsillar abscess without requiring puncture&#46; While this datum confirms the reports published by Kilty et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> it should be taken with caution since&#44; as seen in our study&#44; up to 23&#37; of cases do not present significant trismus&#46; Some authors advocate the use of ultrasound for diagnosis and to conduct guided punctures&#44; as well as computed tomography &#40;CT&#41; in uncooperative paediatric patients&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0110" class="elsevierStylePara elsevierViewall">One of the hypotheses which we considered at the beginning of the study was that an inappropriate use of antibiotics in the treatment of pharyngitis favoured the development of complications&#44; specifically the use of macrolides&#44; due to the high rate of resistance among the Spanish population&#46; However&#44; although most patients were taking antibiotics at the time of diagnosis of peritonsillar infection&#44; we found that only 3&#37; of patients who had taken antibiotics previously had taken a macrolide and most were being treated adequately with amoxicillin&#47;clavulanate&#46; Nevertheless&#44; we believe that not taking the appropriate dosage or failure to adequately comply with the correct antibiotic pattern could be a favouring factor since most authors report a higher rate of peritonsillar infections in patients treated with macrolides&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> In our series we found no relationship between a history of repeated pharyngotonsillitis and the development of peritonsillar infection&#46; This coincides with the findings in other series&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> However&#44; we did observe a relationship between suffering repeated pharyngotonsillitis and suffering more than one episode of phlegmon&#47;abscess&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Management on an outpatient basis or hospitalisation of these patients is a source of disagreement between various authors &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46; While in countries such as the United Kingdom the vast majority of patients are admitted&#44; in the United States they are mostly managed as outpatients&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a> In our series&#44; following the protocol at our service&#44; we admitted these patients in order to administer intravenous antibiotics and provide hydration and nutritional support&#46; Nevertheless&#44; we believe that&#44; following the therapeutic regime of Al Yaghchi et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a> certain patients without risk factors could benefit from outpatient management&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0120" class="elsevierStylePara elsevierViewall">Drainage of the purulent material is part of the treatment &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46; The most appropriate method for this task remains controversial&#44; although both puncture-aspiration and incision-drainage seem to be equally effective&#46;<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">18&#44;21</span></a> In our action protocol&#44; we use puncture-aspiration at the time of diagnosis&#46; According to the leakage or not of purulent material&#44; we classify the infection as phlegmon or abscess&#46; The management guide for peritonsillar abscesses proposed by Herzon et al&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> suggests that puncture-aspiration can be used as the only drainage procedure&#44; as it obtains a resolution rate of 96&#37;&#44; and leaves incision-drainage as an alternative for cases of failure of the first technique&#46; These authors emphasise the scarce discomfort&#44; technical simplicity and low cost of the technique&#44; as well as the fact that it does not require specialised equipment&#46; Some authors advocate performing tonsillectomy immediately after draining the abscess &#40;quinsy or hot tonsillectomy&#41; due to the low rate of complications and recurrences&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a> In our study&#44; most patients evolved adequately without having to repeat the puncture or perform an incision for drainage&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Antibiotic treatment was established empirically&#44; with the first option being intravenous amoxicillin-clavulanate at high doses&#46; This treatment progressed adequately in 84&#37; of cases&#44; including those previously treated with this same combination&#46; From this we can conclude that most resistances remain dose-dependent&#46; We believe that a combination of clindamycin and gentamicin may be an adequate alternative in cases of &#946;-lactam allergy or unfavourable evolution with the first option&#46; Other authors advocate the use of cefotaxime or penicillin alone or combined with metronidazole&#44; with similar results&#46;<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">13&#44;27</span></a> We believe that administration of a single dose of corticosteroids can be very useful&#44; having observed&#44; like other authors&#44; a faster improvement of symptoms such as dysphagia&#44; pain and trismus&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">28</span></a></p><p id="par0130" class="elsevierStylePara elsevierViewall">In accordance with other authors&#44;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">29</span></a> we believe that microbiological identification studies are unnecessary&#44; since empirical therapy is generally effective before culture results are obtained&#46; In addition&#44; many patients take antibiotics previously&#44; so&#44; very often&#44; the results of the culture do not identify the causative agent&#46; Conducting cultures and antibiograms would only be useful in cases of infections with very unfavourable evolution and in immunocompromised patients&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">According to Wikst&#233;n et al&#46; the risk of recurrence is 10&#37;&#8211;15&#37; depending on the follow-up period&#46; This rate increases to 50&#37; in patients younger than 40 years and in those with a history of repeated infections&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">30</span></a> Our recurrence rate was 5&#37;&#44; which would confirm the effectiveness of our protocol&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Regarding the indication for tonsillectomy after an episode of peritonsillar infection&#44; as described in the literature&#44;<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">9&#44;31</span></a> we do not consider having suffered such an episode as an absolute criterion for the intervention&#46; However&#44; in patients with repeated pharyngotonsillitis and in those cases with more than one peritonsillar event&#44; we support the indication of delayed tonsillectomy&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">We have not collected any cases of serious complications during this time period&#44; since cases of mediastinitis&#44; necrotising fasciitis or septic embolisms are more common in severely immunocompromised patients or in those who have suffered a major delay in diagnosis&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">32</span></a></p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conclusions</span><p id="par0150" class="elsevierStylePara elsevierViewall">Peritonsillar infection is the most common complication of bacterial pharyngotonsillitis&#46; Although this entity is likely to cause high morbidity and mortality&#44; it has an excellent prognosis when properly treated&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">Due to the absence of clinical practice guidelines for the management of this disorder there are various treatment protocols&#46; From our experience&#44; we believe that puncture-aspiration in the most convex peritonsillar region and administration of intravenous antibiotics represents a safe and effective protocol in the management of these patients&#46; Further&#44; controlled studies would be required in order to determine the efficacy and safety of management on an outpatient basis compared to hospital admission&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conflict of Interests</span><p id="par0160" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
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            0 => "Peritonsillar infection"
            1 => "Abscess"
            2 => "Cellulitis"
            3 => "Tonsillitis"
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          "clase" => "keyword"
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          "palabras" => array:4 [
            0 => "Infecci&#243;n periamigdalina"
            1 => "Absceso"
            2 => "Flem&#243;n"
            3 => "Amigdalitis"
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        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Peritonsillar infection is the most frequent complication of acute tonsillitis&#46; Peritonsillar infections are collections of purulent material&#44; usually located between the tonsillar capsule and the superior constrictor of the pharynx&#46; Peritonsillar infection can be divided into abscess and cellulitis&#46;</p> <span class="elsevierStyleSectionTitle">Material and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">We prospectively analysed the clinical data from 100 patients with peritonsillar infection from 2008 to 2010&#46; The diagnosis of abscess or peritonsillar cellulitis was primarily based on obtaining pus through fine-needle aspiration&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Seventy-seven percent of patients had no history of recurrent tonsillitis and 55&#37; were receiving antibiotic treatment&#46; Sixty-two cases were peritonsillar abscess and the rest were cellulitis&#46; <span class="elsevierStyleItalic">Trismus</span>&#44; uvular deviation and anterior pillar bulging were statistically associated with peritonsillar abscess &#40;<span class="elsevierStyleItalic">P</span>&#60;&#46;005&#41;&#46; All patients were admitted to hospital and treated with puncture-drainage&#44; intravenous antibiotics &#40;amoxicillin&#47;clavulanate in 83&#37; of cases&#41; and a single dose of steroids&#46; All patients were discharged on oral antibiotic therapy&#46; The mean length of hospital stay was 3 days and the recurrence rate was 5&#37;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Due to the absence of clinical practice guidelines&#44; there are different therapeutic protocols&#46; According to our experience&#44; puncture-aspiration and administration of intravenous antibiotics is a safe&#44; effective way to treat these patients&#46; To determine the efficacy and safety of outpatient management&#44; controlled studies would be needed&#46;</p>"
      ]
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<span class="elsevierStyleSectionTitle">Introducci&#243;n</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">La infecci&#243;n periamigdalina supone la complicaci&#243;n m&#225;s frecuente de una amigdalitis&#46; Se define como una colecci&#243;n purulenta localizada entre la c&#225;psula amigdalar y el m&#250;sculo constrictor superior de la faringe&#46; Puede clasificarse en flem&#243;n y absceso periamigdalino&#46;</p> <span class="elsevierStyleSectionTitle">Material y m&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Presentamos un estudio prospectivo descriptivo de 100 infecciones periamigdalinas diagnosticadas entre los a&#241;os 2008 y 2010&#46; Se analizaron diversas variables cl&#237;nico-epidemiol&#243;gicas y el manejo de estos pacientes&#46; El diagn&#243;stico de flem&#243;n o absceso periamigdalino se bas&#243; fundamentalmente en la obtenci&#243;n de pus mediante punci&#243;n-aspiraci&#243;n&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">El 77&#37; de los pacientes no ten&#237;an antecedentes de amigdalitis de repetici&#243;n y el 55&#37; estaban recibiendo tratamiento antibi&#243;tico&#46; En el 62&#37; de los casos se clasific&#243; como absceso y en el 38&#37; como flem&#243;n periamigdalino&#46; La presencia de <span class="elsevierStyleItalic">trismus</span>&#44; desviaci&#243;n contralateral de la &#250;vula y el abombamiento del pilar anterior se relacion&#243; con la presencia de absceso &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; Todos los pacientes fueron ingresados y tratados con punci&#243;n-drenaje&#44; antibioterapia intravenosa &#40;amoxicilina&#47;clavul&#225;nico en el 83&#37; de los casos&#41; y una dosis de corticoides&#46; Al alta&#44; todos los pacientes recibieron antibioterapia oral&#46; La estancia media fue de 3 d&#237;as y la tasa de recurrencias del 5&#37;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Debido a la ausencia de gu&#237;as de pr&#225;ctica cl&#237;nica&#44; existen diversos protocolos terap&#233;uticos&#46; De acuerdo a nuestra experiencia&#44; la punci&#243;n-aspiraci&#243;n y la administraci&#243;n de antibioterapia intravenosa&#44; es una opci&#243;n segura y eficaz en el manejo de estos pacientes&#46; Para determinar la eficacia y seguridad del manejo ambulatorio o mediante ingreso de estos pacientes&#44; ser&#237;an necesarios estudios controlados&#46;</p>"
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        "nota" => "<p class="elsevierStyleNotepara">Please cite this article as&#58; Costales-Marcos M&#44; et al&#46; Infecciones periamigdalinas&#58; estudio prospectivo de 100 casos consecutivos&#46; Acta Otorrinolaringol Esp&#46; 2012&#59;63&#58;212&#8211;7&#46;</p>"
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                  \t\t\t\t">53 &#40;53&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Female&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34 years &#40;4&#8211;81 years&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Repeated tonsillitis</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23 &#40;23&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Previous peritonsillar infection</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14 &#40;14&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Laterality</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Left&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">59 &#40;59&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Right&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">41 &#40;41&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Mean latency until diagnosis</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 days &#40;2&#8211;7 days&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Prior antibiotic therapy</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">55 &#40;55&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Diagnosis</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Phlegmon&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">62 &#40;62&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Abscess&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">38 &#40;38&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Treatment</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Intravenous amoxicillin&#47;clavulanate&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">83 &#40;83&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Mean hospital stay</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 days &#40;1&#8211;7 days&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Recurrences</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Subsequent tonsillectomy</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26 &#40;26&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Main Clinical and Epidemiological Characteristics&#46;</p>"
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      1 => array:7 [
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            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Symptom&#47;sign&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">No&#46; of patients&#44; &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Odynodysphagia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100 &#40;100&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Bulging of anterior pillar&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">98 &#40;98&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Contralateral displacement of uvula&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">95 &#40;95&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cervical lymphadenopathies&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">80 &#40;80&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Fever&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">70 &#40;70&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Trismus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">77 &#40;77&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ptyalism&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">68 &#40;68&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dysphonia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40 &#40;40&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Uvula hydrops&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28 &#40;28&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dyspnoea&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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            0 => array:3 [
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              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara">Patients normally presented more than 1 symptom&#46;</p>"
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          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Presentation Symptoms in 100 Patients With Peritonsillar Infection&#46;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a></p>"
        ]
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      2 => array:7 [
        "identificador" => "tbl0015"
        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Authors&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Treatment regime&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Number of patients&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Method&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Success&#44; &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Mehanna et al&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">94&#37; hospital&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">101&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">48&#37; punction&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">92&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">6&#37; outpatient&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">52&#37; incision&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">90&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ong et al&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">100&#37; hospital&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">185&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">66&#37; incision&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">34&#37; punction&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">41&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Stringer et al&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">100&#37; outpatient&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Punction&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">92&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Incision&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Herzon et al&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">100&#37; outpatient&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">100&#37; punction&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Ophir et al&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">92&#37; outpatient&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">100&#37; punction&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">8&#37; hospital&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Segal et al&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">100&#37; outpatient&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">75&#46;4&#37; punction 23&#46;8&#37; incision 0&#46;8&#37; <span class="elsevierStyleItalic">quinsy</span> tonsillectomy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Spires et al&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">100&#37; outpatient&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Punction&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Incision&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Maharaj et al&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">100&#37; outpatient&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">30&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Punction&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">87&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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              "identificador" => "bib0005"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "The contemporary approach to diagnosis and management of peritonsillar abscess"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "R&#46;F&#46; Johnson"
                            1 => "M&#46;G&#46; Stewart"
                          ]
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                    ]
                  ]
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                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Curr Opin Otolaryngol Head Neck Surg"
                        "fecha" => "2005"
                        "volumen" => "13"
                        "paginaInicial" => "157"
                        "paginaFinal" => "160"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15908813"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
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              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Absceso periamigdalino con extensi&#243;n parot&#237;dea y perifar&#237;ngea&#46; A prop&#243;sito de un caso"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "G&#46; Barroso Braojos"
                            1 => "E&#46; Raboso Garc&#237;a-Baquero"
                            2 => "J&#46; Mart&#237;nez Sanmill&#225;n"
                            3 => "A&#46; Mart&#237;nez Vidal"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Acta Otorrinolaringol Esp"
                        "fecha" => "2000"
                        "volumen" => "51"
                        "paginaInicial" => "737"
                        "paginaFinal" => "739"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11270112"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Abscesos periamigdalino y retrofar&#237;ngeo&#58; estudio de 13 a&#241;os"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "E&#46; Mart&#237;n Campagne"
                            1 => "F&#46; del Castillo Mart&#237;n"
                            2 => "M&#46;M&#46; Mart&#237;nez L&#243;pez"
                            3 => "C&#46; Borque de Andr&#233;s"
                            4 => "M&#46;I&#46; de Jos&#233; G&#243;mez"
                            5 => "M&#46;J&#46; Garc&#237;a de Miguel"
                          ]
                        ]
                      ]
                    ]
                  ]
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                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "An Pediatr &#40;Barc&#41;"
                        "fecha" => "2006"
                        "volumen" => "65"
                        "paginaInicial" => "32"
                        "paginaFinal" => "36"
                      ]
                    ]
                  ]
                ]
              ]
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              "identificador" => "bib0020"
              "etiqueta" => "4"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Management of peritonsillar abscess"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "D&#46; Maharaj"
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                            2 => "S&#46; Hemsley"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Laryngol Otol"
                        "fecha" => "1991"
                        "volumen" => "105"
                        "paginaInicial" => "743"
                        "paginaFinal" => "745"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1919343"
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                          ]
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              "identificador" => "bib0025"
              "etiqueta" => "5"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Microbiology and management of peritonsillar&#44; retropharyngeal&#44; and parapharyngeal abscesses"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
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                          ]
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                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Oral Maxillofac Surg"
                        "fecha" => "2004"
                        "volumen" => "62"
                        "paginaInicial" => "1545"
                        "paginaFinal" => "1550"
                        "link" => array:1 [
                          0 => array:2 [
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              "identificador" => "bib0030"
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                      "titulo" => "Rational diagnostic and therapeutic management of deep neck infections&#58; analysis of 233 consecutive cases"
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                          "etal" => true
                          "autores" => array:6 [
                            0 => "G&#46; Marioni"
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                            2 => "S&#46; Parisi"
                            3 => "R&#46; Marchese-Ragona"
                            4 => "A&#46; Zuccon"
                            5 => "C&#46; Staffieri"
                          ]
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                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Otol Rhinol Laryngol"
                        "fecha" => "2010"
                        "volumen" => "119"
                        "paginaInicial" => "181"
                        "paginaFinal" => "187"
                        "link" => array:1 [
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                            2 => "C&#46; Schaefer-Prokop"
                            3 => "W&#46; Fokkens"
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                    0 => array:2 [
                      "doi" => "10.1002/lary.20606"
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                        "tituloSerie" => "Laryngoscope"
                        "fecha" => "2009"
                        "volumen" => "119"
                        "paginaInicial" => "1745"
                        "paginaFinal" => "1752"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19551850"
                            "web" => "Medline"
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              "identificador" => "bib0040"
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                      "titulo" => "Analysis of life-threatening complications of deep neck abscess and the impact of empiric antibiotics"
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                          "etal" => false
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                            2 => "Y&#46;S&#46; Lee"
                            3 => "S&#46;H&#46; Huang"
                            4 => "T&#46;A&#46; Chen"
                            5 => "T&#46;J&#46; Fang"
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                    0 => array:2 [
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                        "tituloSerie" => "ORL J Otorhinolaryngol Relat Spec"
                        "fecha" => "2008"
                        "volumen" => "70"
                        "paginaInicial" => "249"
                        "paginaFinal" => "526"
                        "link" => array:1 [
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                      "titulo" => "Tratamiento de la infecci&#243;n periamigdalina"
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                            0 => "F&#46;J&#46; Garc&#237;a Callejo"
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                            3 => "J&#46; Marco Algarra"
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                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "An Pediatr &#40;Barc&#41;"
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                        "volumen" => "65"
                        "paginaInicial" => "37"
                        "paginaFinal" => "43"
                      ]
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            9 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Peritonsillar abscess in early childhood&#46; Presentation and management"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "N&#46;R&#46; Friedman"
                            1 => "R&#46;B&#46; Mitchell"
                            2 => "K&#46;D&#46; Pereira"
                            3 => "R&#46;T&#46; Younis"
                            4 => "R&#46;H&#46; Lazar"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Otolaryngol Head Neck Surg"
                        "fecha" => "1997"
                        "volumen" => "123"
                        "paginaInicial" => "630"
                        "paginaFinal" => "632"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9193226"
                            "web" => "Medline"
                          ]
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                ]
              ]
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            10 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "11"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Peritonsillar abscess or cellulitis&#63; A clinical comparative paediatric study"
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                          "etal" => false
                          "autores" => array:2 [
                            0 => "G&#46; Szuhay"
                            1 => "T&#46;L&#46; Tewfik"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Otolaryngol"
                        "fecha" => "1998"
                        "volumen" => "27"
                        "paginaInicial" => "206"
                        "paginaFinal" => "212"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9711515"
                            "web" => "Medline"
                          ]
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            11 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "12"
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                      "titulo" => "Mosher Award Thesis&#46; Peritonsillar abscess&#58; Incidence&#44; current management practices&#44; and a proposal treatment guidelines"
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                        0 => array:2 [
                          "etal" => false
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                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Laryngoscope"
                        "fecha" => "1995"
                        "volumen" => "105"
                        "paginaInicial" => "117"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "13"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Peritonsillar infections&#58; local experience"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "Y&#46;K&#46; Ong"
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                            2 => "Y&#46;L&#46; Lee"
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                        ]
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                    ]
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                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Singapore Med J"
                        "fecha" => "2004"
                        "volumen" => "45"
                        "paginaInicial" => "106"
                        "paginaFinal" => "109"
                      ]
                    ]
                  ]
                ]
              ]
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            13 => array:3 [
              "identificador" => "bib0070"
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                    0 => array:2 [
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                          "etal" => false
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                            2 => "H&#46;M&#46; Zeitoun"
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                      "doi" => "10.1308/003588411X579793"
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                        "tituloSerie" => "Ann R Coll Surg Engl"
                        "fecha" => "2011"
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                        "paginaFinal" => "355"
                        "link" => array:1 [
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21943456"
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                          "etal" => false
                          "autores" => array:5 [
                            0 => "S&#46; Kordeluk"
                            1 => "L&#46; Novack"
                            2 => "M&#46; Puterman"
                            3 => "M&#46; Kraus"
                            4 => "B&#46;Z&#46; Joshua"
                          ]
                        ]
                      ]
                    ]
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1177/0194599811415802"
                      "Revista" => array:6 [
                        "tituloSerie" => "Otolaryngol Head Neck Surg"
                        "fecha" => "2011"
                        "volumen" => "145"
                        "paginaInicial" => "940"
                        "paginaFinal" => "945"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21810775"
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                      "titulo" => "Clinical predictors of peritonsillar abscess in adults"
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                          "etal" => false
                          "autores" => array:2 [
                            0 => "S&#46;J&#46; Kilty"
                            1 => "I&#46; Gaboury"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Otolaryngol Head Neck Surg"
                        "fecha" => "2008"
                        "volumen" => "37"
                        "paginaInicial" => "165"
                        "paginaFinal" => "168"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19128606"
                            "web" => "Medline"
                          ]
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                  ]
                ]
              ]
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              "identificador" => "bib0085"
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                    0 => array:2 [
                      "titulo" => "National audit of the management of peritonsillar abscess"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "H&#46;M&#46; Mehanna"
                            1 => "L&#46; Al-Bahnasawi"
                            2 => "A&#46; White"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Postgrad Med J"
                        "fecha" => "2002"
                        "volumen" => "78"
                        "paginaInicial" => "545"
                        "paginaFinal" => "548"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12357017"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
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              "identificador" => "bib0090"
              "etiqueta" => "18"
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                      "titulo" => "A randomized trial for outpatient management of peritonsillar abscess"
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                          "autores" => array:3 [
                            0 => "S&#46;P&#46; Stringer"
                            1 => "S&#46;D&#46; Schaefer"
                            2 => "L&#46;G&#46; Close"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Otolaryngol Head Neck Surg"
                        "fecha" => "1988"
                        "volumen" => "114"
                        "paginaInicial" => "296"
                        "paginaFinal" => "298"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3422562"
                            "web" => "Medline"
                          ]
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              "etiqueta" => "19"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Peritonsillar abscess&#46; A prospective evaluation of outpatient management by needle aspiration"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "D&#46; Ophir"
                            1 => "J&#46; Bawnik"
                            2 => "Y&#46; Poria"
                            3 => "M&#46; Porat"
                            4 => "G&#46; Marshak"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Otolaryngol Head Neck Surg"
                        "fecha" => "1988"
                        "volumen" => "114"
                        "paginaInicial" => "661"
                        "paginaFinal" => "663"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3163252"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0100"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Peritonsillar abscess in children in the southern district of Israel"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "N&#46; Segal"
                            1 => "S&#46; El-Saied"
                            2 => "M&#46; Puterman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ijporl.2009.04.021"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Pediatr Otorhinolaryngol"
                        "fecha" => "2009"
                        "volumen" => "73"
                        "paginaInicial" => "1148"
                        "paginaFinal" => "1150"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19481820"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Treatment of peritonsillar abscess&#46; A prospective study of aspiration <span class="elsevierStyleItalic">vs</span> incision and drainage"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J&#46;R&#46; Spires"
                            1 => "J&#46;J&#46; Owens"
                            2 => "G&#46;E&#46; Woodson"
                            3 => "R&#46;H&#46; Miller"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Otolaryngol Head Neck Surg"
                        "fecha" => "1987"
                        "volumen" => "113"
                        "paginaInicial" => "984"
                        "paginaFinal" => "986"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3606850"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Peritonsillar abscess&#46; Clinical and microbiologic aspects and treatment regimens"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "S&#46; Savolainen"
                            1 => "H&#46;R&#46; Jousimies-Somer"
                            2 => "A&#46;A&#46; Makitie"
                            3 => "J&#46;S&#46; Ylikoski"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Otolaryngol Head Neck Surg"
                        "fecha" => "1993"
                        "volumen" => "119"
                        "paginaInicial" => "521"
                        "paginaFinal" => "524"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8484941"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Peritonsillar abscess&#58; repeated needle aspiration versus incision and drainage"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46; Wolf"
                            1 => "I&#46; Even-Chen"
                            2 => "J&#46; Kronenberg"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Otol Rhinol Laryngol"
                        "fecha" => "1994"
                        "volumen" => "103"
                        "paginaInicial" => "554"
                        "paginaFinal" => "557"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8024219"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prospective audit on the outpatient management of patients with a peritonsillar abscess&#58; closing the loop&#58; how we do it"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "G&#46; Garas"
                            1 => "S&#46; Ifeacho"
                            2 => "R&#46; Cetto"
                            3 => "A&#46; Arora"
                            4 => "N&#46; Tolley"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1749-4486.2011.02255.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Otolaryngol"
                        "fecha" => "2011"
                        "volumen" => "36"
                        "paginaInicial" => "174"
                        "paginaFinal" => "179"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21518279"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Out-patient management of patients with a peritonsillar abscess"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "C&#46; Al Yaghchi"
                            1 => "A&#46; Cruise"
                            2 => "K&#46; Kapoor"
                            3 => "A&#46; Singh"
                            4 => "J&#46; Harcourt"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1749-4486.2007.01575.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Otolaryngol"
                        "fecha" => "2008"
                        "volumen" => "33"
                        "paginaInicial" => "52"
                        "paginaFinal" => "55"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18302556"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0130"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Peritonsillar abscess-critical analysis of abscess tonsillectomy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "A&#46;A&#46; Dunne"
                            1 => "O&#46; Granger"
                            2 => "B&#46;J&#46; Folz"
                            3 => "A&#46; Sesterhenn"
                            4 => "J&#46;A&#46; Werner"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Otolaryngol"
                        "fecha" => "2003"
                        "volumen" => "28"
                        "paginaInicial" => "420"
                        "paginaFinal" => "424"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12969344"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0135"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The microbiology and antibiotic treatment of peritonsillar abscess"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46; Prior"
                            1 => "P&#46; Montgomery"
                            2 => "I&#46; Mitchelmore"
                            3 => "S&#46; Tabaqchali"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Otolaryngol"
                        "fecha" => "1995"
                        "volumen" => "20"
                        "paginaInicial" => "219"
                        "paginaFinal" => "223"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7554331"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib0140"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Use of steroids in the treatment of peritonsillar abscess"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "C&#46; Ozbek"
                            1 => "E&#46; Aygenc"
                            2 => "E&#46;U&#46; Tuna"
                            3 => "A&#46; Selcuk"
                            4 => "C&#46; Ozdem"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1258/002221504323219563"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Laryngol Otol"
                        "fecha" => "2004"
                        "volumen" => "118"
                        "paginaInicial" => "439"
                        "paginaFinal" => "442"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15285862"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib0145"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Use of bacteriologic studies in the management of peritonsillar abscess"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "T&#46;G&#46; Nelson"
                            1 => "T&#46; Hayat"
                            2 => "H&#46; Jones"
                            3 => "M&#46;D&#46; Weller"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1749-4486.2008.01861.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Otolaryngol"
                        "fecha" => "2009"
                        "volumen" => "34"
                        "paginaInicial" => "88"
                        "paginaFinal" => "89"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19260906"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib0150"
              "etiqueta" => "30"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Who ends up having tonsillectomy after peritonsillar infection&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J&#46; Wikst&#233;n"
                            1 => "M&#46; Hyt&#246;nen"
                            2 => "A&#46; Pitk&#228;ranta"
                            3 => "K&#46; Blomgren"
                          ]
                        ]
                      ]
                    ]
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00405-007-0306-0"
                      "Revista" => array:3 [
                        "tituloSerie" => "Eur Arch Otorhinolaryngol"
                        "fecha" => "2011"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17453227"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib0155"
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Quinsy tonsillectomy or interval tonsillectomy-a prospective randomised trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46;J&#46; Fagan"
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                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "S Afr Med J"
                        "fecha" => "1994"
                        "volumen" => "84"
                        "paginaInicial" => "689"
                        "paginaFinal" => "690"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7839259"
                            "web" => "Medline"
                          ]
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                      ]
                    ]
                  ]
                ]
              ]
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Parapharyngeal abscess&#58; diagnosis&#44; complications and management in adults"
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                          "etal" => false
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                            0 => "A&#46; Alaani"
                            1 => "H&#46; Griffiths"
                            2 => "S&#46;S&#46; Minhas"
                            3 => "J&#46; Olliff"
                            4 => "A&#46;B&#46; Lee"
                          ]
                        ]
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                    ]
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                    0 => array:2 [
                      "doi" => "10.1007/s00405-004-0800-6"
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                        "tituloSerie" => "Eur Arch Otorhinolaryngol"
                        "fecha" => "2005"
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                        "paginaInicial" => "345"
                        "paginaFinal" => "350"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15235797"
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Article information

ISSN: 21735735
Original language: English

DOI:10.1016/j.otoeng.2012.01.013

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2019 October	79	10	89
2019 September	48	4	52
2019 August	28	13	41
2019 July	46	24	70
2019 June	51	44	95
2019 May	95	44	139
2019 April	40	23	63
2019 March	16	10	26
2019 February	23	11	34
2019 January	17	5	22
2018 December	12	14	26
2018 November	24	14	38
2018 October	26	8	34
2018 May	1	0	1
2018 April	8	12	20
2018 March	7	5	12
2018 February	8	1	9
2018 January	12	5	17
2017 December	11	6	17
2017 November	12	8	20
2017 October	12	6	18
2017 September	14	12	26
2017 August	18	6	24
2017 July	22	7	29
2017 June	26	23	49
2017 May	21	13	34
2017 April	20	8	28
2017 March	21	37	58
2017 February	11	6	17
2017 January	3	4	7
2016 December	12	6	18
2016 November	16	10	26
2016 October	35	10	45
2016 September	13	9	22
2016 August	19	10	29
2016 July	22	5	27
2016 June	33	12	45
2016 May	39	11	50
2016 April	27	10	37
2016 March	27	12	39
2016 February	30	20	50
2016 January	22	7	29
2015 December	20	14	34
2015 November	23	16	39
2015 October	22	19	41
2015 September	16	12	28
2015 August	14	9	23
2015 July	16	11	27
2015 June	9	4	13
2015 May	22	13	35
2015 April	23	25	48
2015 March	28	11	39
2015 February	29	9	38
2015 January	53	10	63
2014 December	61	11	72
2014 November	37	5	42
2014 October	64	14	78
2014 September	46	5	51
2014 August	46	8	54
2014 July	47	5	52
2014 June	42	4	46
2014 May	42	6	48
2014 April	25	11	36
2014 March	34	8	42
2014 February	28	5	33
2014 January	13	8	21
2013 December	18	6	24
2013 November	15	7	22
2013 October	69	10	79
2013 September	20	10	30
2013 August	11	1	12
2013 July	1	1	2

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